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Chapter-05 And It Came Back Yet Again: Medical Aspects of Postmenopausal Endometriosis

BOOK TITLE: Manual of Clinical Dilemma in Mature Women

Author
1. Khandelwal Sunila
ISBN
9789352703739
DOI
10.5005/jp/books/18026_6
Edition
1/e
Publishing Year
2018
Pages
6
Author Affiliations
1. Mid-life Women Health Care & Menopause Centre, Fortis Escorts & Apex Hospital, Jaipur, Rajashthan, India
Chapter keywords
Endometriosis, radical surgery, endometrium, menopausal hormone treatment, hormone therapy, surgical therapy, medical treatment

Abstract

Endometriosis is a common chronic benign gynecological disease affecting about 6–10% of all women. It is characterized by the presence of endometrium like tissue outside the uterine cavity, primarily on the ovaries and is an estrogen dependent condition generally limited to reproductive age. It progresses mostly in cases of moderate and severe disease but spontaneous regression can occur in 58% of milder cases. The purpose of medical and conservative surgical treatment of endometriosis is often to relieve symptoms in anticipation of a naturally occurring menopause. Occasionally, it is necessary to perform radical surgery with hysterectomy and bilateral oophorectomy to control symptoms and to avoid further surgery. Use of menopausal hormone treatment in women with prior history of endometriosis raises concerns in the mind of clinicians about disease recurrence with pain symptoms, need for surgery and possibly malignant transformation of residual endometriosis.

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